Bring Back That Lovin' Feeling

Not in the mood for sex? How you and your husband can recapture that spark and learn the secrets of true intimacy.

For decades, much has been said  out loud  about sex. And yet, behind closed doors, many of the same problems that have plagued women for generations  issues of confidence and confusion  still exist. Some women have grown up uninterested in sex; other women are finding that, as they've aged, their interest in sex has diminished greatly.

Years ago, a little blue pill called Viagra radically changed people's sex lives. Because of this and other, newer drugs, marriages that had been coasting on mutual sexual dysfunction  the husband was unable to have sex, and the wife was quite happy to go without it  changed dramatically. Many wives have come to me and said, "I was fine with the way it used to be; I don't need sex." Yet they now have an extremely aroused husband to contend with, and his interest is unlikely to wane.

Some studies have found that one in three women lacks an interest in sex. But that can change. While it's true that low desire can be caused by medical problems, it's essential to uncover and understand the psychological factors behind it. Your lack of desire may have many causes. Here are the questions women most frequently ask me and how I advise them.

Q: I have sex with my husband even though I don't really want to. Is that okay?

A: This may be the question I get asked most often by women. It's late, you're tired, but your husband initiates sex, and it seems like less effort to simply go along with his wishes than to start a fight. Many a woman buys into the idea that she has to be passive and agreeable and give her man what he wants. And, of course, there is also the desire to please your husband  it's natural not to want him to feel rejected and frustrated, so many women try to be giving in this way. But it's not really giving if you're not a participant. What gets most men really excited is seeing their wives aroused. You can't think, As long as I'm there and I'm willing, then it's all okay. True, your partner may appreciate that it's better than having no sex, but he certainly can tell an enthusiastic partner from an "if I have to" lump. Giving in, rather than figuring out how to make sex an enjoyable prospect for you, is not the answer. You're denying yourself the intimacy and the fun you could be having. So what's holding you back? You may be thinking, I'm so angry with him, the last thing I feel like doing is giving him pleasure. Or you may resent the fact that your spouse isn't taking your fatigue into consideration. Feelings like that can and should be addressed. And if being intimate with your spouse doesn't feel physically good, then your motivation is going to plummet. Remember, there's no man who can't do what you want if you show him and tell him. A man who wants to have a good sex life is going to realize that intimacy is about more than what is satisfying for only him.

Q: Is it okay if my husband and I are both fine without sex?

A: It's important to acknowledge that having a sex life doesn't have to mean having sexual intercourse. Intimate contact of any kind with your spouse is what is essential. Human beings are by nature sexual creatures with an innate desire to touch, cuddle and feel. If you lack interest in even these things, there is likely to be some underlying psychological reason, such as guilt about sex, low self-esteem, depression, or dissatisfaction with your relationship. Some people will need counseling, but just awareness about what's really going on is half the battle.

If you've experienced a sudden lack of desire, you should have your hormone levels checked to see if there is a medical cause. But you may need to consider the psychological causes too. You could have performance anxiety, negative feelings about your body, or misconceptions about what it means to be sexual. Once you've figured out what's inhibiting you, tell your partner. If it's fear, your spouse needs to understand that fear. If it's shame or embarrassment about some aspect of sex, your spouse needs to know that you aren't ready to swing from chandeliers. If there's something he says or does that bothers you, he can't know it's a problem unless you say something. Starting a dialogue may seem difficult, but a few awkward moments are certainly worth it if the result is a far more fulfilling relationship.

Q: What if I want to have sex but my husband doesn't?

A: Wanting more sex than your husband does can be very embarrassing, and women take it very personally. It can lead you to wonder, What is the matter with me? Nothing. Wanting sex doesn't mean you're dirty or strange. The truth is, many men suffer from low libido. But when a woman wants to be intimate and her husband doesn't, she often feels that his rejection must have something to do with her desirability. She may even think he's having an affair!

And yet, a man will often avoid sex because he is having potency problems and is afraid of risking failure. This is why it's so important to discuss his lack of interest in a supportive and loving way. Avoid becoming distressed about it because that's going to drive him farther away from the bedroom. He may also be having a medical problem; diabetes and cardiovascular disease can cause erectile dysfunction. Or, he may be angry or depressed about something, unbeknownst to you. You can't know the problem until you begin a dialogue. Ask directly if he is avoiding sex because of concerns about his erection, because he's angry with you or because he's lost sexual interest (a sign of low testosterone, which can be treated). Working to resolve the problem will bring you closer together  and asking for what you want sexually will make you feel better about yourself.

Q: How do I know if low desire is due to a physical problem?

A: Testosterone is the hormone of desire, and it can drop after menopause. Estrogen replacement therapy can also lower testosterone. Your gynecologist can test for this and prescribe replacement testosterone (although giving testosterone is controversial, due to the potential for risky side effects). Many medications can also decrease desire (these include antihypertensives, antidepressants, sedatives, antihistamines, ulcer medications, and oral contraceptives). And postmenopausal women who are not on hormone replacement therapy may experience decreased lubrication and thinning of the vaginal walls, which can make sex painful. But estrogen and vitamin E creams can help.

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